Outcomes of pediatric distal tibial physeal fractures
Emile Blondin1, Olivier Stourbe1, Marie-Christine Plancq1
1Service d'Orthopédie et Traumatologie pédiatrique, CHU Amiens-Picardie, Groupe Hospitalier Sud, 80054 Amiens Cedex 1, France.
Background:
Fractures of the distal tibia involving the physis are relatively common in children. The data reported on long-term complication rates vary between studies.
Hypothesis:
Pediatric distal tibial fractures cause medium- and long-term growth disturbances.
Materials And Methods:
This was a retrospective single-center study. We included physeal distal tibial fractures that were treated in the operating room with a minimum 12-month follow-up. The analysis included age, gender, weight status, circumstances and energy of the injury, fracture type, subsequent treatment, complications, duration of follow-up, radiologic findings and functional outcomes using the AOFAS.
Results:
A total of 46 patients were included with a mean age of 12.8 years (2.4-15.9 years) and a mean follow-up of 35.8 months (12-119). At the longest follow-up, 7 patients (15.2%) had growth disturbances. The mean AOFAS score was 95/100 and a decreased ankle range of motion was observed in 18 patients, but it was always less than 10°. High-energy injuries (20 patients) resulted in worse clinical outcomes and a significantly higher rate of growth disturbances (p=.03).
Discussion:
This study confirmed the presence of growth disturbances following pediatric distal tibial fractures, especially in cases of high-energy trauma. Therefore, these fractures should be monitored until the end of the growth period.
Level Of Evidence:
IV; retrospective study.
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